Currently, the most read article the website of the Journal of the American Medical Association is not an article about Covid-19, cancer, heart disease, diabetes, or obesity. It’s about whether ‘shrooms treat depression. The article entitled “Single-Dose Psilocybin Treatment for Major Depressive Disorder” has been viewed 127,745 times since it was released less than a month ago. That’s more than double the views of the two most read Covid-19 articles this month
Agreed. And I do think we've missed out on some opportunity with these "schedule I" drugs (drugs thought to have no medical use--which is clearly b.s., but is also a big matter of dosing). So we'll see. I'll write about the ketamine data sometime.
My brother had success with the micro dosing. I have a diagnosis of GAD (General Anxiety Disorder) and have been fortunate to have incredible access to top therapy in the field. I am so grateful as the journey can be very difficult for some at times. My Psychiatrist prescribed ketamine (even though there is more research for use in depression) as I was really in a difficult place. After two sessions It unlocked a whole bunch which at the time did not help me; however for some it might. Looking back that might have been the purpose, it was just not for me. I continued with more intensive traditional therapy used for people with anxiety and OCD and was thankful to put those tools in place. What you are doing with this newsletter can and is making a big difference, so thank you.
Reading Michael Pollan ("How to Change Your Mind"), the people (including the author) receiving this treatment were NOT "stoner" types who were in it for the trip; most were deeply depressed. The friends I know who have benefited from this treatment had experienced a major trauma, and it enabled them to start functioning and sleeping relatively normally. I'd personally like to have this available, despite firmly maintaining that reality is more than weird enough. I suppose it's possible that the (volunteer) subjects in the study had underlying interest in hallucinogen use - but one would think that those supervising it would have tried to weed them out.
there's a study of ketamine where the patients were asleep when the drug was given (for medical procedures). That was good blinding...but I'll eventually write about why that was not a great idea!
I find it notable, and possibly relevant, that psilocybin can provide an alternative perception of reality that includes feelings of awe. During that “awesome time”, as one possible effect, if a common rumination were to cross their mind, it might appear trivial and less painful, and perhaps reshape their perception going forward? Or, if the therapist is with them during the awe-inspiring event, they may be able to recall the awe (possibility of change/hope) with them.
Cults and Multilevel Marketing seminars (inner circle members) intentionally create awe and get people to be happy/love bombed, that appear to cure many psychological maladies during induction. But, when reality returns and the active ingredient no longer has the same awe-inspiring effect, will the long term results continue or may they even prompt an additional existential despair?
Back in the day, I was a keen observer of how the kids in the dorms reacted to psychedelics after I helped someone having a “bad shroom trip” to the ED because psilocybin triggered something that evolved into schizophrenia. Many students who used shrooms were definitely happier and wanted to “dose the world so everyone could be happy, and war and hate would end” meanwhile, their cognitive functions appeared to markedly decline, and the frequent users left college. One happy kid who supposedly used a lot of “pure” psychedelics (chemistry majors) worked at the local shop and just gave everything away because making so many people happy made him even happier, that is until he was finally arrested. All uncontrolled experiments, to be sure. I obviously have concerns about using psilocybin as a treatment.
I've definitely observed the phenotype of people for whom mind-altering substances unmasked (over time) the potential for very devastating psychiatric disease. There are some people who really should not get near THC or psilocybin, etc. (The question is, can we identify them in a way that reliably helps them avoid that path.) Meanwhile, there are many (most?) who probably have close to zero risk from these substances in the right doses. And that's a big thing we didn't discuss: dose. The question is, do low doses of these compounds offer something therapeutic? If the dose is low enough that the recreational upside is mostly dampened *and* without the risk of situations like the ones you're described...then that would be great. The question is: do such doses retain medicinal value or do they risk being sort of homeopathic/ineffective doses.
Yes this is one criticism of the paper: participants had to taper off their meds. Makes sense for control purposes and learning about the study drug. But also does not necessarily resemble real life.
I wonder if it could be a comparison study by providing a rare activity usually deemed to be “awe inspiring” and provide time to contemplate while walking through nature on the way home. I wonder if both experiences would have similar results on depression. What is the operational definition of an awe inspiring event? I dunno, large groups manufacture them and nature phenomena provide them all the time, maybe something less spectacular but with a squirt of oxytocin.
Oh I love this point. This is the problem with yoga and tai chi studies. I'm always like...is this better than going for a walk? Is it the discipline of yoga or tai chi? Or is it just a way to get your mind in a certain "head space" and that things that slow your day down and make you appreciate the world can also do.
I flew to Amsterdam twice to a retreat for psilocybin. The retreat's participants were studied by the Imperial College London. My first experience was somewhat helpful despite intense nausea but the effects wore off so back I went. The second experience was not helpful. I felt as if I had the flu and the experienced staff could not explain this ( I later read not uncommon side effect).
I next tried ketamine here under a doctor's care and though the series of doses (4 days with increasing amounts) helped somewhat the following "booster" left me dizzy and severely nauseated. I will stick to my trusty but not completely effective antidepressants.
I expect adjustment for weight and age might minimize the side effects.
Though not a scientific evaluation this is one person's search for relief from persistent depressive disorder.
I am grateful that research is continuing to help those who do suffer from depression. It is a horrible disease.
Agreed. And I do think we've missed out on some opportunity with these "schedule I" drugs (drugs thought to have no medical use--which is clearly b.s., but is also a big matter of dosing). So we'll see. I'll write about the ketamine data sometime.
My brother had success with the micro dosing. I have a diagnosis of GAD (General Anxiety Disorder) and have been fortunate to have incredible access to top therapy in the field. I am so grateful as the journey can be very difficult for some at times. My Psychiatrist prescribed ketamine (even though there is more research for use in depression) as I was really in a difficult place. After two sessions It unlocked a whole bunch which at the time did not help me; however for some it might. Looking back that might have been the purpose, it was just not for me. I continued with more intensive traditional therapy used for people with anxiety and OCD and was thankful to put those tools in place. What you are doing with this newsletter can and is making a big difference, so thank you.
Reading Michael Pollan ("How to Change Your Mind"), the people (including the author) receiving this treatment were NOT "stoner" types who were in it for the trip; most were deeply depressed. The friends I know who have benefited from this treatment had experienced a major trauma, and it enabled them to start functioning and sleeping relatively normally. I'd personally like to have this available, despite firmly maintaining that reality is more than weird enough. I suppose it's possible that the (volunteer) subjects in the study had underlying interest in hallucinogen use - but one would think that those supervising it would have tried to weed them out.
Thank you for your insights about the difficulty of a truly blind study here. And, yes, still could be promising
there's a study of ketamine where the patients were asleep when the drug was given (for medical procedures). That was good blinding...but I'll eventually write about why that was not a great idea!
I find it notable, and possibly relevant, that psilocybin can provide an alternative perception of reality that includes feelings of awe. During that “awesome time”, as one possible effect, if a common rumination were to cross their mind, it might appear trivial and less painful, and perhaps reshape their perception going forward? Or, if the therapist is with them during the awe-inspiring event, they may be able to recall the awe (possibility of change/hope) with them.
Cults and Multilevel Marketing seminars (inner circle members) intentionally create awe and get people to be happy/love bombed, that appear to cure many psychological maladies during induction. But, when reality returns and the active ingredient no longer has the same awe-inspiring effect, will the long term results continue or may they even prompt an additional existential despair?
Back in the day, I was a keen observer of how the kids in the dorms reacted to psychedelics after I helped someone having a “bad shroom trip” to the ED because psilocybin triggered something that evolved into schizophrenia. Many students who used shrooms were definitely happier and wanted to “dose the world so everyone could be happy, and war and hate would end” meanwhile, their cognitive functions appeared to markedly decline, and the frequent users left college. One happy kid who supposedly used a lot of “pure” psychedelics (chemistry majors) worked at the local shop and just gave everything away because making so many people happy made him even happier, that is until he was finally arrested. All uncontrolled experiments, to be sure. I obviously have concerns about using psilocybin as a treatment.
I've definitely observed the phenotype of people for whom mind-altering substances unmasked (over time) the potential for very devastating psychiatric disease. There are some people who really should not get near THC or psilocybin, etc. (The question is, can we identify them in a way that reliably helps them avoid that path.) Meanwhile, there are many (most?) who probably have close to zero risk from these substances in the right doses. And that's a big thing we didn't discuss: dose. The question is, do low doses of these compounds offer something therapeutic? If the dose is low enough that the recreational upside is mostly dampened *and* without the risk of situations like the ones you're described...then that would be great. The question is: do such doses retain medicinal value or do they risk being sort of homeopathic/ineffective doses.
Shouldn't they just have compared psilocybin to standard of care, like SSRIs or something?
Yes this is one criticism of the paper: participants had to taper off their meds. Makes sense for control purposes and learning about the study drug. But also does not necessarily resemble real life.
I wonder if it could be a comparison study by providing a rare activity usually deemed to be “awe inspiring” and provide time to contemplate while walking through nature on the way home. I wonder if both experiences would have similar results on depression. What is the operational definition of an awe inspiring event? I dunno, large groups manufacture them and nature phenomena provide them all the time, maybe something less spectacular but with a squirt of oxytocin.
Oh I love this point. This is the problem with yoga and tai chi studies. I'm always like...is this better than going for a walk? Is it the discipline of yoga or tai chi? Or is it just a way to get your mind in a certain "head space" and that things that slow your day down and make you appreciate the world can also do.
I wonder how many people taking placebo truly believed they were wasted (reminds me of Adam Sandler's bit in 1993)
https://www.youtube.com/watch?v=J3j8SJS3nBg
I flew to Amsterdam twice to a retreat for psilocybin. The retreat's participants were studied by the Imperial College London. My first experience was somewhat helpful despite intense nausea but the effects wore off so back I went. The second experience was not helpful. I felt as if I had the flu and the experienced staff could not explain this ( I later read not uncommon side effect).
I next tried ketamine here under a doctor's care and though the series of doses (4 days with increasing amounts) helped somewhat the following "booster" left me dizzy and severely nauseated. I will stick to my trusty but not completely effective antidepressants.
I expect adjustment for weight and age might minimize the side effects.
Though not a scientific evaluation this is one person's search for relief from persistent depressive disorder.